Primary prevention
Although the relationship between Reye's syndrome and aspirin use has not been clearly defined, the risk to benefit ratio of any medication should be considered. Therefore, avoiding salicylate use in children is recommended.[5] This includes salicylates found in natural remedies and other medications.[15]
As influenza and varicella are the viral infections most frequently associated with Reye's syndrome, routine immunisation schedules, as directed by local guidelines, should be followed.
In the US, routine immunisation for influenza is recommended for all children from 6 months to 18 years, and varicella-zoster vaccine for infants at 12 months with a second dose at 4 to 6 years of age, because these are both recognised infectious aetiologies. Other less common infectious pathogens for which there are preventive vaccines include rubella, measles, and polio; it would seem prudent that these vaccines should also be given.
Inborn errors of metabolism may mimic Reye's syndrome. These include urea cycle disorders, glycogen storage disease, organic acidaemias, primary carnitine deficiency, hereditary fructose intolerance, and fatty acid oxidation defects.[4] Careful management of these conditions with dietary modification may reduce acute Reye's-like illness.
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